Methods: Sixty patients with RDH were randomly divided into two equal groups: the first group underwent revision discectomy alone and the second underwent revision discectomy with fusion. The primary outcomes evaluated were Visual Analog Scale (VAS) for low back and limb pains, Oswestry Disability Index (ODI), disc height indexes, foraminal height index, and disc height subsidence. Secondary outcomes included operative time, blood loss, postoperative hospital stay, and complications. Results: Revision discectomy with fusion showed superior pain relief and improved functional outcomes, including better VAS scores for both back and leg pain and ODI at 24-month follow-up. Additionally, it restored the stability of the spine better with lower disc height subsidence without significant complications. However, these advantages came at the cost of increased blood loss and longer operative time and hospital stays. Conclusions Revision discectomy with fusion is recommended for RDH; however, the choice of the procedure should be made caseby- case basis, considering many factors related to the patient and surgical facilities.

Objectives: This study aimed to determine the prevalence of parental stress in patients with schizophrenia spectrum disorder and the contributing factors. Methods: This is a cross-sectional study involving 115 patients with schizophrenia spectrum disorder who were attending an outpatient psychiatric clinic, recruited through universal sampling. Those who fulfilled the selection criteria and gave informed consent were selected. Socio-demographic data, perceived parenting capacity, children’s data, and illness data were obtained from the patient during interview as well as from the clinical notes. Presence of parental stress and severity of psychiatric symptoms were measured using Parental Stress Scale (PSS) and Brief Psychiatric Rating Scale (BPRS) respectively. Descriptive analysis was performed, followed by univariate analysis and multiple logistic regression analysis, using International Business Machines (IBM®) Statistical Package for Social Science (SPSS) version 24. Results: 60 out of 115 participants (52.2%) had parental stress. Factors associated with parental stress include ethnicity (p=0.032), total household income (p=0.004), parenting children with mental or learning disability (p=0.022), perceived financial inadequacy (p=0.049), perceived food inadequacy (p=0.049), and presence of psychiatric symptoms (p=0.001). Ethnicity, total household income, parenting children with mental or learning disability, and presence of psychiatric illness were the predictors for parental stress among patients with schizophrenia spectrum disorder. Conclusion Parental stress is prevalent in this group. Hence, health care professionals should be able to identify the risk factors and to provide them with necessary support

Objective: To document the clinical, biochemical and imaging phenotypes of immunocompetent patients with adrenal histoplasmosis. Methods: The clinical, biochemical and radiologic data of 18 immunocompetent patients [age: 45.00 (39.25, 56.25) years, median (IQR), m/f (16/2)] with adrenal histoplasmosis presenting in the Department of Endocrinology, BSMMU between 2014 and 2020 were retrospectively analyzed. Results: All patients were seronegative for HIV infection, and 27.8% (5/18) had well controlled diabetes mellitus. The median duration of the symptoms was 6.00 (IQR: 4.00, 11.25) months. All had significant weight loss, anorexia and weakness. Fever was present in 61.1% (11/18) patients and night sweat was present in 27.8% (5/18) cases. Hypotension and hyperpigmentation were present in 55.6% (10/18) and 66.7% (12/18) cases, respectively. Three of 18 patients presented with adrenal crisis. Hyponatremia occurred in 55.6% (10/18) cases, but none had hyperkalemia. Thirteen of 18 patients had adrenal insufficiency whereas 83.3% (15/18) had high adrenocorticotropic hormone. CT scan revealed bilateral adrenal enlargement in all cases with oval shape and regular margin. All were hypodense having radiodensity 21-90 hounsfield unit, and 11.1% (2/18) were heterogeneous in contrast enhancement. None had noticeable calcification whereas 1.1% (2/18) cases had central necrosis with peripheral rim enhancement. Hepatomegaly was present in 6 cases, splenomegaly in 3 cases and 5 patients had abdominal lymphadenopathy. Histoplasmosis were confirmed by positive fine needle aspiration cytology of adrenal tissue. Conclusions: Adrenal histoplasmosis should be considered in the list of differentials of bilateral adrenomegaly in immunocompetent individuals even living in non-endemic areas.

An outbreak of dengue in Kudat, northern Sabah in 2016-2017 provided an opportunity to investigate the circulating serotypes of dengue viruses of cases at Hospital Kudat. Between September 2016 and December 2017, a total of 156 dengue positive sera (tested positive by either NS1 antigen, or IgM & IgG antibody rapid test) were collected from dengue patients who had acute fever and showed signs and symptoms suggestive of dengue. RNA was extracted from the sera using QIAamp RNA Blood Mini Kit, and molecular amplification was performed using one-step RT-PCR kit, followed by nested PCR using HotStart Taq master mix kit with the primers of the dengue C-prM gene. There were 81 (52%) male and 75 (48%) female cases. The age group with the highest number of cases was the 10-19 years old, while the youngest infected was 8 months old and the oldest was 83 years old. RT-PCR results showed 88 sera dengue positive, 48 infected with a single serotype while another 40 with multiple serotypes. All four DENV serotypes were co-circulating during the outbreak period and DENV-1 was predominant. Molecular analysis also indicated 69.2%, 50.0%, 51.9% and 48.9% respectively of the NS1, IgM, IgG and IgM & IgG positive sera were RT-PCR positive for dengue. High number of cases were seen in December 2016, February and May 2017. The dengue outbreak might be related to switching of predominant serotype from DENV 4 to DENV 1.

OBJECTIVE: To evaluate the protective effect of Zataria multiflora extract, an antioxidative medicinal plant, against cyclophosphamide (CP)-induced oxidative lung damage in mice. METHODS: Mice were intraperitoneally pre-treated with various doses of Zataria multiflora extract (50, 100, 200, and 400 mg/kg) once daily for 7 consecutive days. Animals were then injected with a single 200 mg/kg intraperitoneal dose of CP 1 h after the last administration of O. vulgare. Twenty-four hours later, mice were euthanized, the lungs were immediately removed, and biochemical and histological studies were conducted. RESULTS: A single dose of CP markedly altered the levels of several biomarkers associated with oxidative stress in lung homogenates. Pretreatment with Zataria multiflora significantly inhibited the elevation of lipid peroxidation level and the depletion in glutathione content, and superoxide dismutase and catalase activities induced by CP in lung. In addition, Zataria multiflora effectively alleviated CP-induced histopathological abnormality and pulmonary damages in mice lung tissues. CONCLUSIONS The results reveal that Zataria multiflora protects lung tissues from CP-induced toxicity and suggest a role for oxidative stress in the pathogenesis of lung toxicity produced by CP in mice. Because Zataria multiflora has been extensively used as an additive agent and is regarded as safe, it may be used concomitantly as a good supplement for reducing organ toxicity in patients undergoing chemotherapy, besides their consolidated ethnopharmacological uses.

OBJECTIVES: The aims of the research are to examine the problems of abnormal menopausal women: the relationship between depression and menopausal-specific quality of life (MENQOL)-symptoms among postmenopausal women; the association of MENQOL-symptoms between pre- and postmenopausal female society in Bangladeshi real community. METHODS: This cross sectional study was conducted on 435 women of Tangail, aged (≥ 17) years, using a structured questionnaire where is inaacluded the information of MENQOL and one of the main outcomes “depression” is measured by beck depression inventory. RESULTS: Menopausal status and MENQOL symptoms (except pain) are significantly (P < 0.05) associated. By using post-hoc analysis, the proportion of menopausal women, classified as having a depressive mood of early menopause is significantly higher than natural-menopause. Among postmenopausal women, there is a significant correlation between “concentration problem” and “depression”. Here mean depression score (29.40 ± 6.42) of menopausal women who have any difficulty in concentrating is higher than mean depression score (20.89 ± 6.64) of menopausal women who have no difficulty in concentrating. Another six factors (osteoporosis, heart-beating, fatigue, pressure, tingling, headaches) of MENQOL-symptoms were significantly correlated with depression and P-values are 0.000, 0.000, 0.000, 0.033, 0.006, and 0.002, respectively. Finally the presence of “difficulty in concentrating” and “fatigue” are strongly associated factors with depression score (P < 0.001). CONCLUSIONS: The early postmenopausal women have to face more psychological problems (e.g., depression) compare to others. Among postmenopausal women, there is no significant relation between depression and vasomotor symptom (e.g., hot-flashes) perspective to menopausal female society of Bangladesh.
Bangladesh* ; Cross-Sectional Studies* ; Depression* ; Fatigue ; Female ; Humans ; Menopause ; Quality of Life*

OBJECTIVES: Every physical abnormal criterion has an impact on the health. Late menopause causes different physiological problems which alike early menopause. The research interest is associated with both early and late menopausal women of Bangladesh as only few menopausal studies available in South East Asia especially in Bangladesh. The aims of this study are not only to assess the symptoms of menopausal abnormality but also to determine the impact of these symptoms on the quality of life (QOL) of the female society in Bangladesh. METHODS: Data mining techniques are used to rank the 22 factors (conducted with questionnaire) commonly associated with menopause. Among the participants menstruation that stops before 45 years was considered as early menopausal status and after 50 years as late menopausal. The mean of age and mean length of time in years, since menopause for all participants were 61.55±10.7 and 14.13±11.17, respectively. Recorded data indicated 67% were early menopausal women and 33% were late menopausal women. RESULTS: Results indicated that feeling tired or lacking in energy and dizziness (83%) and depression (82%) have worst impact on QOL among all factors, respectively. The next prevalent symptoms included hot flashes (64%), osteoporosis (72%), sweating at night (63%), concentration problem (75%), irritability (63%), feeling tense (77%), headache (66%). However, less frequent factors included breathing problems (33%), loss of feeling (31%), coherent heart disease (13%) and type2 diabetics (9%). CONCLUSION: Our study indicates that early menopausal women are facing more physiological problems than the late menopausal women on their QOL.
Bangladesh ; Data Mining ; Depression ; Dizziness ; Far East ; Female ; Headache ; Heart Diseases ; Hot Flashes ; Humans ; Menopause ; Menstruation ; Osteoporosis ; Quality of Life* ; Respiration ; Sweat ; Sweating ; Transcutaneous Electric Nerve Stimulation

Accessory breast is a frequently seen developmental breast abnormality, commoner among Asians than Caucasians. This ectopic breast tissue shares many similarities as the normal breast tissue, and although subjected to the same pathological processes, accessory breast carcinoma is rare. As locations of the accessory breast may be variable, detection of pathological lesions through clinical examinations and standard diagnostic tools (i.e., mammogram) can be difficult. Staging and management should be tailored-made according to the location of the accessory breast as well as its known pattern of lymphatic drainage. We report a case of an intra-ductal carcinoma occurring in an axillary accessory breast.

Objective: To investigate the phytochemical screening (group determination) and selected pharmacological activities (antioxidant, antimicrobial and analgesic activity) of the plant Sida cordifolia Linn (S. cordifolia).
Methods: Eighty percent concentrated ethanol extract of the roots was used. To identify the chemical constituents of plant extract standard procedures were followed. In phytochemical screening the crude extract was tested for the presence of different chemical groups like reducing sugar, tannins, saponins, steroids, flavonoids, gums, alkaloids and glycosides. The antioxidant property of ethanolic extract of S. cordifolia was assessed by DPPH free radical scavenging activity. Analgesic activity of the extract was tested using the model of acetic acid induced writhing in mice. Diclofenac sodium is used as reference standard drug for the analgesic activity test. Antibacterial activity of plant extract was carried out using disc diffusion method with five pathogenic bacteria comparison with kanamycin as a standard.
Results:Phytochemical analysis of the ethanolic extract of the roots of S. cordifolia indicated the presence of reducing sugar, alkaloids, steroids and saponins. In DPPH scavenging assay the IC50 value was found to be 50 μg/mL which was not comparable to the standard ascorbic acid. The crude extract produced 44.30%inhibition of writhing at the dose of 500 mg/kg body weight which is statistically significant (P>0.001). The in vitro antimicrobial activity of the ethanol extract of the roots of S. cordifolia showed no antimicrobial activity against five types of microorganisms. The experiment was conducted only with five species of bacteria as test species, which do not at all indicate the total inactivity against micro-organisms.
Conclusions: The obtained results provide a support for the use of this plant in traditional medicine but further pharmacological studies are required.

This study investigates work engagement of employed breast cancer survivors in comparison to unmatched control samples of healthy working women without cancer and any other chronic diseases from the general population. A case-control study design using unmatched controls was adopted in this study. The case comprised of 80 female breast cancer survivors who have returned to full-time employment selected using purposive sampling technique. Meanwhile, controls were 88 healthy female working women in full time paid employment, selected using quota sampling. Questionnaire covering socio-demographic characteristics and self-rated work engagement measured using Utrecht Work Engagement Scale (UWES) was distributed to the cancer survivors through face-to-face meeting during their hospital visits. For the healthy controls the questionnaires were distributed using drop-and-collect method through the human resource personnel of the participating organization. The results revealed, after controlling for age, marital status, ethnic group and tenure with organization, no significant differences in the overall work engagement was found between the breast cancer survivors [mean (SD) = 4.66 (0.92)] and the healthy controls [mean (SD) = 4.75 (0.85)]; F(1, 163) =1.70. In comparison to the work engagement domains, only the Vigor domain was found to be significantly lower for the survivors, survivors [F (1, 163) =14.94; p<.001] compared to healthy controls. However, the effect size was small (2= 0.004). No significant difference was found in the mean absorption and dedication domain scores. The findings suggest, except for vigor domain, work engagement of breast cancer survivors who have returned to work do not differ from individuals without cancer.​
Breast Neoplasms ; Survivors ; Work